steroids exacerbating reflux?

[AmberM]

I took my dd to the pediatrician this morning to go over our Cuningham results and he agreed that we need some serious help. He raised the abx dosage to 200mgs of azithro from the 75mgs our previous dr had her on and are planning to do a 30 day steroid taper starting on monday. He mentioned that he was a little nervous about giving the steroids because of my dd's acid reflux. I guess the medrolpred can exacerbate reflux? He suggested trying to give mylanta at the same time of day as the steroids and I was wondering if anyone else has experienced this before?

 

My daughter is 3yrs old and nonverbal. When she has reflux episodes, she becomes completely inconsolable and self injurious so I'm a little terrified. But at the same time I'm very determined to get her out of this PANDAS. We'll suffer through if needed but I thought someone may have some tricks. She currently takes a high dose of Prilosec at bedtime as well and it does seem to help for the most part but she has been waking up lately screaming and I can't tell if she's having the reflux or some kind of night terror type of episode.

 

-Amber

[kimballot]

My son takes omeprazole for reflux and recently completed a 2-week steroid burst. He did complain of increased reflux the first few days when the steroid was loading. I remember that we increased his omeprazole to twice a day for probably 3 or 4 days... then we were able to go back down to once a day. In our case it was worth it because the prednisone ended the sinusitis and the PANDAS symptoms continue to decrease.

 

Will someone be able to be with your daughter to intervene if she does have the reflux and self-injurious behaviors during the steroid burst?

 

If you decide to do the steroids you probably want to have as much reflux intervention as possible in your arsenol before you begin. Be careful with the diet, and time of day she eats, use mylanta, and anything else you can do. Does she take anything else for reflux?

 

Also, maybe have a "steroid exit plan" in place before you begin in case you need to end earlier. I believe you cannot just stop giving steroids, so maybe discuss a withdrawal protocol so you can start it if you need to.

 

Best wishes -

[AmberM]

Thanks so much for the advice. Audrey is on omeprazole once a day but I think I may ask her pedi what the max dose is we could use if necessary. I'm with her all day except for 3hr in the morning when she goes to preschool but her teacher is pretty good with helping her through a bad episode. I'm really hoping the steroids help her.

-Amber